Chapter 20 Neurological Disorders

Chapter 20  Neurological Disorders

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which of the following statements is true about Parkinson disease (PD)?
a.
Drinking large amounts of alcohol can relieve symptoms of essential tremor.
b.
Motor tremors and slow movement accompany severe cognitive impairment.
c.
Lewy body dementia (LBD) is the most common form of dementia.
d.
Older adults taking rasagiline (Azilect) must avoid eating foods containing tyramine.

ANS: D
Older adults taking rasagiline (Azilect) must avoid eating foods containing tyramine; interactions of rasagiline with tyramine can cause sudden, severe hypertension.
Drinking small amounts of alcohol can relieve symptoms of essential tremor, although heavy drinking should be avoided. The majority of persons with PD remain alert and intelligent, but motor difficulties in facial expression and speech can give a false impression of cognitive impairment. LBD, which can occur in some patients with PD symptoms, is the second most common form of dementia. It accounts for 15% to 20% of all dementias.

PTS: 1 DIF: Remember REF: 10-11
TOP: Nursing Process: Assessment MSC: Physiological Integrity

2. An older man comes to the emergency department after falling at home, and he reports that he cannot walk without losing his balance. Which steps should the nurse implement for this patient?
a.
Arrange to transfer him immediately to the radiology department.
b.
Determine symptom onset or when he fell at home.
c.
Organize the reperfusion tissue plasminogen activator (tPA) infusion.
d.
Perform a comprehensive neurologic assessment.

ANS: B
The nurse determines when the symptoms first appeared or the time of the fall to determine whether sufficient time is left to administer reperfusion tPA; if indicated, tPA must be administered within 3 hours of symptom onset. A patient with clinical indicators of a stroke will need a computed tomographic (CT) scan to differentiate between a thrombotic stroke and a hemorrhagic stroke; the type of stroke will determine the therapeutic course. The time of symptom onset is a vital piece of information that must be determined before the patient is referred to the radiology department because tPA is usually administered in the radiology suite. Administering tPA can be contraindicated for this patient; therefore the preparation of this infusion is delayed until the type of stroke and the plan of care are determined. The nurse will not have enough time to complete a comprehensive assessment and thus will perform a focused assessment in preparation for the trip to radiology.

PTS: 1 DIF: Application REF: 22
TOP: Nursing Process: Implementation MSC: Physiological Integrity

3. Which of the following statements is true about dysarthria?
a.
Does not affect intelligence.
b.
Stems from severe rheumatoid arthritis.
c.
Physical therapy can be beneficial.
d.
Can affect the balance.

ANS: A
Dysarthria is a speech disorder caused by a weakness or incoordination of the speech muscles. It occurs as a result of central or peripheral neuromuscular disorders that interfere with the clarity of speech and pronunciation; it does not affect intelligence. It does not stem from rheumatoid arthritis. Occupational therapy can help. Dysarthria does not affect balance.

PTS: 1 DIF: Understand REF: 16-17| 33-34
TOP: Nursing Process: Assessment MSC: Physiological Integrity

4. A new nurse in a long-term care facility is caring for a patient with PD. The nurse should note which one of the following actions related to PD that is observed during the assessment?
a.
Tremors during sleep
c.
Frequent blinking
b.
Cogwheel rigidity
d.
Fast movements

ANS: B
Patients with PD display slow movement, infrequent blinking, masked facies, and cogwheel rigidity. Patients with PD exhibit tremors at rest in their hands, arms, legs, feet, and jaw.

PTS: 1 DIF: Understand REF: 32
TOP: Nursing Process: Assessment MSC: Physiological Integrity